THE INTERRELATIONSHIPS OF TARDIVE-DYSKINESIA, PARKINSONISM, AKATHISIAAND TARDIVE DYSTONIA - THE CURACAO EXTRAPYRAMIDAL SYNDROMES STUDY .2.

A study of the four extrapyramidal syndromes (EPS), tardive dyskinesia , parkinsonism, akathisia and tardive dystonia, was performed in the N etherlands Antilles, a well-defined catchment area with only one psych iatric hospital. The population under study (N=194; mean age 53.1) was mainly Afro-Caribbean, and most patients were chronic. The severity o f each EPS was measured with valid and reliable rating scales. The pur pose was to study both the strength of the inter-relationships of EPS and the prevalence of combinations of EPS. The inter-relationships bet ween the EPS were analyzed by means of logistic regression. The adjust ed odds ratios between the various EPS revealed strong connections bet ween the hyperkinetic syndromes (tardive dyskinesia, tardive dystonia and akathisia). Parkinsonism was found to be inversely related to tard ive dyskinesia and to tardive dystonia. Almost 30% of the patients suf fered from two or more EPS. The highest prevalence rates of combinatio ns were: tardive dyskinesia combined with parkinsonism 12.9%, tardive dyskinesia combined with tardive dystonia 9.8%, and tardive dyskinesia combined with akathisia 5.2%. Our findings show a strong positive cor relation between hyperkinetic forms of EPS, Furthermore, chronic psych iatric inpatients regularly suffer from combinations of EPS. Different treatment strategies are suggested for various combinations of EPS. ( C) 1997 Elsevier Science B.V.